By MIKE STOBBE (AP Medical Writer)

NEW YORK (AP) — The number of U.S. fatal overdoses fell last year, according to Centers for Disease Control and Prevention data posted Wednesday.

Agency officials noted the data is provisional and could change after more analysis, but that they still expect a drop when the final counts are in. It would be only the second annual decline since the current national drug death epidemic began more than three decades ago.

Experts reacted cautiously. One described the decline as relatively small, and said it should be thought more as part of a leveling off than a decrease. Another noted that the last time a decline occurred — in 2018 — drug deaths shot up in the years that followed.

“Any decline is encouraging,” said Brandon Marshall, a Brown University researcher who studies overdose trends. “But I think it’s certainly premature to celebrate or to draw any large-scale conclusions about where we may be headed long-term with this crisis.”

It’s also too soon to know what spurred the decline, Marshall and other experts said. Explanations could include shifts in the drug supply, expansion of overdose prevention and addiction treatment, and the grim possibility that the epidemic has killed so many that now there are basically fewer people to kill.

CDC Chief Medical Officer Dr. Deb Houry called the dip “heartening news” and praised efforts to reduce the tally, but she noted “there are still families and friends losing their loved ones to drug overdoses at staggering numbers.”

About 107,500 people died of overdoses in the U.S. last year, including both American citizens and non-citizens who were in the country at the time they died, the CDC estimated. That’s down 3% from 2022, when there were an estimated 111,000 such deaths, the agency said.

The drug overdose epidemic, which has killed more than 1 million people since 1999, has had many ripple effects. For example, a study published last week in JAMA Psychiatry estimated that more than 321,000 U.S. children lost a parent to a fatal drug overdose from 2011 to 2021.

“These children need support,” and are at a higher risk of mental health and drug use disorders themselves, said Dr. Nora Volkow, director of the National Institute on Drug Abuse, which helped lead the study. “It’s not just a loss of a person. It’s also the implications that loss has for the family left behind.”

Prescription painkillers once drove the nation’s overdose epidemic, but they were supplanted years ago by heroin and more recently by illegal fentanyl. The dangerously powerful opioid was developed to treat intense pain from ailments like cancer but has increasingly been mixed with other drugs in the illicit drug supply.

For years, fentanyl was frequently injected, but increasingly it’s being smoked or mixed into counterfeit pills.

A study published last week found that law enforcement seizures of pills containing fentanyl are rising dramatically, jumping from 44 million in 2022 to more than 115 million last year.

It’s possible that the seizures indicate that the overall supply of fentanyl-laced pills is growing fast, not necessarily that police are whittling down the illicit drug supply, said one of the paper’s authors, Dr. Daniel Ciccarone of the University of California, San Francisco.

He noted that the decline in overdoses was not uniform. All but two of the states in the eastern half of the U.S. saw declines, but most western states saw increases. Alaska, Washington, and Oregon each saw 27% increases.

The reason? Many eastern states have been dealing with fentanyl for about a decade, while it’s reached western states more recently, Ciccarone said.

Nevertheless, some researchers say there are reasons to be optimistic. It’s possible that smoking fentanyl is not as lethal as injecting it, but scientists are still exploring that question.

Meanwhile, more money is becoming available to treat addiction and prevent overdoses, through government funding and also through legal settlements with drugmakers, wholesalers and pharmacies, Ciccarone noted.

“My hope is 2023 is the beginning of a turning point,” he said.

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AP medical writer Carla K. Johnson contributed to this report.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

Mobilization for Justice has been operating for more than 12 weeks without the workers who typically execute its mission to combat economic injustice—its more than 100 unionized staff. 

Adi Talwar

Unionized employees of Mobilization for Justice, Inc. (MFJ) picketing outside MFJ’s Manhattan office on Feb. 27th, 2024.

For more than 12 weeks running, the legal services provider Mobilization for Justice (MFJ) has been operating without the workers who typically execute its mission to combat economic injustice—its more than 100 unionized staff. 

Now, New York City Comptroller Brad Lander is investigating the impact of this short-handedness. Specifically in city housing courts, where, prior to February’s strike announcement, over 40 staff attorneys helped tenants fight eviction and sue their landlords to win building repairs.

MFJ workers deserve a fair contract, Lander said in a statement, as they are “on the front lines to protect people from losing the roof over their heads” yet “also struggle to make ends meet.” 

In a letter sent Wednesday to Department of Social Services (DSS) Commissioner Molly Park, Lander requested reports for February through May detailing eviction casework that MFJ has performed during the strike under city contracts. Non-union supervisors and directors are currently handling tenant representation, the organization confirmed. 

DSS administers the city’s novel Right to Counsel program through its Office of Civil Justice (OCJ). Passed into law in 2017, Right to Counsel is intended to provide low-income tenants with free lawyers from organizations including MFJ. 

The effort has been hailed a success—last fiscal year, 84 percent of represented tenants were able to stay in their homes—but it has yet to be funded to meet demand, despite a $20 million increase baselined in last year’s budget.  

Lander’s office tracks the city’s representation rate for eviction cases, which hit a low of 24 percent for cases filed in December, and has since rebounded to 53 percent for February cases. (The tool does not filter for income eligibility.) 

“We would like to better understand the impact that MFJ management’s failure to reach a resolution with their employees has had on the city’s ability to implement one of its cornerstone programs to prevent eviction and homelessness,” Lander’s letter states. 

It goes on to request anonymized reports including the number of new eviction cases opened each day; the outcomes of each court appearance; breakdowns of service outcomes like rental assistance and negotiated buyouts; and all attorney activities, including trials, hearings, motions and appeals. 

Reached by email prior to the letter’s release, MFJ Chief Development Officer Eric Alterman told City Limits that the organization would not comment on issues related to a potential investigation. “Brad Lander’s office has not reached out to MFJ regarding an investigation, though our counsel has inquired to no avail,” he wrote. 

MFJ workers, including attorneys, paralegals and support staff, are members of the Legal Services Staff Association (LSSA) Local 2320, part of the United Auto Workers. They went on strike in mid-February, after rejecting a contract offer they said fell short of their needs, including fair pay and remote work flexibility. 

In addition to housing, members specialize in foreclosure, bankruptcy, immigration, government benefits and disability rights.

One of the union’s primary demands is a $60,000 salary floor for non-attorneys. Support staff salaries under the last contract started at about $51,000, while paralegals started around $53,000. 

MFJ has now agreed to meet this demand, Alterman told City Limits by email. The latest offer also includes a larger cost-of-living adjustment (COLA): at least 4 percent in the first year, 2 percent in the second year and 3 percent in the third year, up from 2 percent annually in the offer that set off the strike. 

“The $60,000, finally engaging with us on that is very welcome,” said Brenden Ross, a member of the union’s bargaining team and senior staff attorney with MFJ’s Mental Health Law Project. “We’re at a place where I think we can say we’re hopeful we’re moving toward each other.” 

But the bargaining team is not yet satisfied with the COLA, pointing to Mayor Eric Adams’ March announcement of a roughly 9 percent cost-of-living boost for human services workers. “To see them not even hitting 3 in that second year, it feels like it’s not reorienting to developments in funding,” Ross said. 

Another major sticking point is the union’s demand that MFJ rehire a temporary worker who they say was terminated after filing a labor grievance seeking permanent employee status. Alterman called this a mischaracterization, saying MFJ asked the staffing agency to “reassign the individual to a different job” in light of the grievance. 

“Our members feel strongly about rehiring to fight back against retaliation,” said Ella Abeo, a bargaining committee member and housing paralegal in the Bronx. “Reinstating their job would bring the union and management close enough to end the strike.” 

Meanwhile, MFJ attorneys have been visiting housing courts in Manhattan and the Bronx to observe how their managers and supervisors are getting by in their absence. 

“It’s important for the other stakeholders in this to be reminded—such as judges, clients, opposing counsel—that we’re not picketing a few times a week and that’s that,” said staff attorney Payton Fisher, who has helped organize the effort. 

Sean Davis is a staff attorney with the Mental Health Law Project, and has made a handful of visits to Manhattan Housing Court during the strike. He told City Limits Tuesday that he has observed numerous case adjournments. 

“I can say with certainty that our clients are not receiving the same level of representation as they were,” he said. “What I’ve seen is a lot of adjournments. Sometimes that’s strategic, sometimes that’s a good thing for our clients, but in this case it seems to be a tactic to buy time.” 

Courts only offer so many adjournments before a case must be settled or go to trial, Davis continued. “I anticipate unionized staff coming back to cases that look substantively different, deviating from strategy,” he said. 

Alterman of MFJ pushed back on the inadequate representation claims, calling them false. Managers are meeting daily with clients, he said, filing motions and going to trial. MFJ has 12 housing-focused supervisors, he added, who have resolved over 150 cases during the strike, and made over 100 appearances monthly. 

“MFJ supervisors and directors—the experienced housing attorneys who supervise union staff, who they learn from every day—are continuing to provide our clients with the highest level of representation and expertise, despite incredibly high caseloads,” Alterman wrote.  

In a statement to City Limits prior to Lander’s data request, a DSS spokesperson said the city’s mandate to provide legal services supersedes the contractual obligations of any given contractor. 

“We are aware of the issues our provider-partner MFJ is facing which impact their entire scope of services, including the city’s Right to Counsel program, and we’re responding with urgency to address any immediate impact by diverting relevant cases to other providers,” the statement read. 

But the union has criticized these diversion efforts, accusing the Human Resources Administration (HRA), part of DSS, of helping the organization perform work despite the strike, and has urged the City Council to withhold funding from MFJ as long as the strike continues. MFJ received $6.8 million for its Right to Counsel efforts in the year ending June 30, according to DSS. 

“Please inform MFJ that the Council will not fund the organization while this strike continues, and specifically as MFJ’s management needlessly prolongs it,” said staff attorney Lisa Meehan at a recent city budget hearing. “We’re concerned that continuing to fund MFJ while the strike goes on may lead to many people continuing to receive inadequate representation.” 

Bronx Councilmember Carmen De La Rosa, who chairs the Committee on Civil Service and Labor, supports the demand, her office confirmed Tuesday. 

“New York’s cost of living is increasing—a fact MFJ knows well through their clientele’s stories,” De La Rosa said in a written statement. “MFJ must commit to bargaining in good faith and meet the basic demands of their workers. We continue to show solidarity with those on strike until a fair contract is presented.” 

As the strike continues, it is already superlative in length. On April 30, the union announced that they are now in the city’s longest legal services strike since a 15-week Legal Services for New York walk-out settled in 1991. 

It will go on until management presents the union with a strong enough offer to discourage burnout and attrition, according to Davis. “We are doing this for our clients,” he said. The next bargaining session is scheduled for Thursday. 

Comptroller Lander to DSS Commissioner Park, 5.14.2024 by City Limits (New York) on Scribd

To reach the reporter behind this story, contact Emma@citylimits.org. To reach the editor, contact Jeanmarie@citylimits.org

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It’s April Fool’s Day in Eagle Pass, but there’s nothing to laugh about here. On a cloudy spring evening, a dozen activists and spiritual leaders gather in a circle—just feet from the bank of the Rio Grande and a miles-long maze of concertina wire—with white carnations, daisies, and hymn lyrics in hand.

This group has come for months now to sing, pray, and toss flowers in the river. Since last year, when Texas Governor Greg Abbott ramped up border militarization in the area by placing dangerous buoys in the river, these mourners have assembled under the moniker the Border Vigil to remember the lives of those lost crossing.

The contrast here—between the U.S. and Mexican sides of the river—is jarring. On the Texas side, shipping containers form a makeshift wall that wasn’t here until a few years ago. Barbed wire tops cyclone fencing, extending almost as far as the eye can see. Shelby Park, typically a riverside gathering spot for Eagle Pass families, now looks like a fortress. Atop the shipping containers, an armed National Guard member stands in uniform, performing his imperious, taxpayer-funded surveillance. But, apart from the vigil, almost nothing is happening here. Shortly before I arrived, I’m told, a drone was buzzing over the activists. 

(Francesca D’Annunzio)

On both sides of the río, birds sing. The peaceful sounds contrast with the military personnel and police officers. The birds flit across the river, and one lands on the tree next to me. They don’t even bother to fly through the official port of entry.

On the Coahuila side, colorful murals welcome visitors. There are more trees and, in the distance, a hike-and-bike trail. There are also three men fishing—an activity that’s not possible from where I’m standing; since the state took over the area in January, locals tell me Shelby Park is often closed to civilians, barring special permission to come in. 

Every civilian in the park this evening is here for the vigil, and that’s only because they got approval ahead of time. Today, we needed permission from the Texas Military Department (TMD) to mourn migrants who drowned right here. Last week, over email, a TMD chaplain originally told one of the vigil organizers that reporters wouldn’t be allowed, but I was ultimately let in without hassle. In a later email to the Texas Observer, a spokesperson for the military department claimed: “The community continues to have access to the park, as does the media.”

On the edge of what used to be an easily accessible boat ramp, the mourners gather to sing. Some have traveled far to bear witness here; a handful of representatives of the American Friends Service Committee, a Quaker group, came from Washington D.C., Atlanta, and Baltimore. 

In Spanish and English, the mourners sing: “Amazing grace, how sweet the sound, que a un infeliz salvó.” They recite Bible verses about welcoming strangers, immigrants, and refugees.

“Treat the stranger who lives among you as one of your own. Love him as yourself,” Eagle Pass resident and Lutheran deacon Mike Garcia reads aloud, adding: “We want to pray for immigrants and refugees who seek a better life in our country. We pray for those who work to defend their rights.”

Julio Vásquez, a pastor at a local church, has personal experience as a stranger in a new place. He immigrated to the United States from El Salvador 24 years ago. He leads the group’s recitation of the Lord’s Prayer. “Padre nuestro, que estás en el cielo, santificado sea tu nombre…”

Amerika Garcia Grewal, one of the main organizers of the Border Vigil and Mike’s daughter, hands out white carnations and daisies. One by one, everyone walks down to the edge of the boat ramp, now overgrown with grass, where the shipping containers and razor wire meet the river. They toss their flowers in.

Two puppies, roaming the river banks, sniff our feet. Amerika says she’s seen National Guard soldiers feed these dogs and teach them tricks. But she doesn’t see them offer aid to migrants. Today, she saw guardsmen yelling at a woman and her child, stuck amid the concertina wire on the U.S. side, trying to claim asylum. 

I throw my white carnations in the river, thinking of a friend of mine from the Syrian city of Aleppo. ISIS and bombs came to her neighborhood, so her family left. She’s a U.S. citizen now, but not so long ago she and her family were lost in a Turkish forest, trying desperately to reach Europe. Instead, they eventually managed to find refuge in Texas. All across the world, people like my friend, people like the mother and child yelled at by the Texas soldiers, are right now fighting their way to safety.

(Francesca D’Annunzio)

If you’re born on my side of the river, you’re afforded dignity—otherwise, you’re welcomed by concertina wire and border security theatrics.

After the ceremony’s conclusion, a strong wind picks up. Lightning flashes. To ward off the gale, guardsmen cover themselves with human-size, clear plastic shields. 

One of the Quaker visitors points out the shields. “What could those be for other than pushing people back into the river?” he asks me.

All this—the shipping containers, shields, deadly buoys, razor wire, drones, guns—just because some people are born on the other side of a river.